Pooled Analysis of Gastric Emptying in Patients With Obesity: Implications for Oral Absorption Projection

胃排空 医学 肥胖 药代动力学 内科学 胃肠病学 子群分析 荟萃分析 科克伦图书馆
作者
Chenxi Lu,Xiao-Xiao An,Yichao Yu,Li-Rong Jiao,Daniele Canarutto,Guo‐Fu Li,Guo Yu
出处
期刊:Clinical Therapeutics [Elsevier BV]
卷期号:43 (10): 1768-1788 被引量:10
标识
DOI:10.1016/j.clinthera.2021.08.006
摘要

Purpose Gastric emptying time is one of limiting factors that determines the pharmacokinetic properties of drugs administered by mouth. Despite the high prevalence of obesity worldwide, modifications in gastric emptying time have not been systematically addressed in this set of patients. The current analysis aims to quantitatively address obesity-related changes in gastric emptying time of solids, semisolids, and liquids compared with lean individuals, highlighting the relevant pharmacokinetic implications of oral drug absorption in patients with obesity. Methods We searched the Cochrane Library, PubMed, Web of Science, and Embase for all relevant articles published until November 1, 2020. Differences in gastrointestinal variables in relation to gastric emptying between obese and lean individuals were quantified by weighted mean difference (WMD) and ratio of means (RoM). Robustness of the analyses was evaluated by subgroup analysis and publication bias test. Findings A total of 17 studies with 906 participants were included. The gastric half-emptying time of solids (WMD, −10.4 minutes; P = 0.001; RoM, 0.90; P = 0.01) and liquids (WMD, −6.14 minutes; P < 0.001; RoM, 0.83, P = 0.03) was significantly shorter in individuals with obesity compared with lean individuals. These findings were confirmed by the subgroup analyses and publication bias tests. Implications Our pooled analysis systemically quantifies the differences in gastric half-emptying time between individuals with obesity and lean individuals, facilitating better understanding and prediction of drug absorption in individuals with obesity through physiologically based pharmacokinetic approaches. Obesity is associated with a faster transit of both solids and liquids through the stomach.
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